U.S. deaths from cardiovascular diseases continue to decline. The Minnesota Heart Survey (MHS) is exploiting a unique opportunity to document and explain trends in coronary heart disease (CHD) and stroke mortality and morbidity between 1970 and 1987. One of the first to develop this dynamic epidemiology of simultaneous community trends, the MHS now has the opportunity to provide 15-year trends (1970-1985) in CHD death out of hospital, in hospitalization rates, case fatality and survivorship for myocardial infarction and acute stroke in a large metropolitan area. Continuation of this project will also provide the first systematic data on change in all major cardiovascular risk factors, and health-related behaviors over an 8-year period (1980-87) in a metropolitan area. In addition to this evidence on trends and their causes, this study provides data directly comparable to other U.S. (Community Cardiovascular Surveillance Program - CCSP) and international studies (World Health Organization-Coordinated Project on Multinational Monitoring of Trends and Determinants in Cardiovascular Diseases -WHO/MONICA) of coronary morbidity and risk factor trends because those studies have worked with MHS to ensure comparability. Unlike these studies, the MHS will continue to monitor case severity and hospital care and to develop further surveillance methodology. Continuation of the MHS will allow the first simultaneous long-term monitoring or mortality, morbidity and risk factor trends and the development and testing of new monitoring methods for detection, explanation and perhaps prediction of cardiovascular disease trends.